- Email: [email protected]
David Barnardo
Perspectives
Historical keyword Nutrition From the Latin nutrire, to suckle, nurse, or nourish, the word came into English via Middle French to mean supplying or receiving nourishment—a meaning that it retains to this day. The importance of proper nutrition was recognised early: Hippocrates advised, “let your food be your medicine and your only medicine be your food”—an idea that has echoes in the modern expression “you are what you eat”. The word is rarely used figuratively, although the idea of “spiritual nutrition” appears in religious writings of the 16th and 17th centuries. Nutrition was also used from an early period for the nutritive contents or properties of food itself. Although foods and diets have been central to medical treatments since ancient times, only in the 19th century was research begun into specific nutritive properties. It has been said that James Lind’s 18thcentury researches into the treatment of scurvy initiated the modern scientific era of nutrition and its clinical investigation, but there was a long gap after Lind before the science of nutrition was begun. From the late 19th century nutrition began to acquire two further meanings. First, it was applied to the condition of being well or badly nourished. By the later 20th century, it was overlaid with economic notions of global division and was modified to “malnutrition” and “overnutrition”. Second, nutrition came to mean the study of food and diet, the branch of science that deals with nutrition. It was first used in this disciplinary sense in the journal Science in 1903. After the discovery of vitamins in the early 20th century, nutrition research became more sophisticated. The concept of “proper” nutrition, which had simply involved a full belly, now became complex. Nutrition also became a political issue during the depression of the 1930s, and has remained so, whether the concern is healthy school meals in the UK or food aid in developing countries. The weight of its political importance has, of course, changed over time, as have medical understandings of “proper”. By the 1990s, “proper” nutrition seemed to be significant in preventing a range of important illnesses, including heart disease and several cancers, although the quantification of the nutrients that “should” be eaten by each person, accommodating individual variation, remains problematic. Turkey good, Christmas pudding and brandy butter bad: but how much, dear doctor, how much?
Anne Hardy Wellcome Trust Centre for the History of Medicine at UCL [email protected]
www.thelancet.com Vol 366 December 17/24/31, 2005
Lifeline David Barnardo studied at the London Hospital, in the UK, and the Mayo Clinic, in the USA, before specialising in gastroenterology at Queen Mary’s Hospital, Roehampton, UK. Formerly a Board member of Tearfund, he has long been active in third-world development issues and, in retirement, chairs the children’s charity that bears his family name. What has been the greatest achievement of your career? Concluding my years of medical practice as chair of Barnardo’s, the UK’s premier children’s charity. And the greatest embarrassment? Taking a liver biopsy from a prominent public figure and driving over the container as I left the car park—biopsy retrieved from within the tyre tread. Who is your favourite politician and why? Tony Wedgewood-Benn, for uncompromising consistency, plain speech, and wit. Who was your most influential teacher and why? John Wright, physician at “The London” who sat on beds, held patients hands, and taught me humanity as a counterbalance to science, since patients are people. What do you think is the greatest political danger to the medical profession? Allowing politicians to come between us and our patients. What would be your advice to a newly qualified doctor? Enjoy the practice of medicine to the full and guard this against intrusion by bureaucracy. What alternative therapies have you tried? A hot water bottle at bedtime works wonders. What are you currently reading? Rough Crossings by Simon Schama—more examples of mankind’s self-deception and hypocrisy. What items do you always carry with you? Safety pin, paper clip, and elastic band. Do politics, spirituality, or religion play an important part in your life? Yes: we all need to seek spiritual as well as scientific answers to the big questions; for me, these are not mutually exclusive but complementary. With which historical figure do you most identify? My great-grandfather’s brother, Thomas John Barnardo (1845–1905). As a 21-year-old medical student, he committed his life to addressing the dreadful conditions that children had to endure in the east end of London—and then nationally. In his lifetime he provided care to 60 000 children, without distinction on grounds of race, religion, or disability (hence the ubiquitous sign “No Destitute Child Ever Refused Admission”). Barnardo’s now works annually with 140 000 children in various ways, but no longer through orphanages.
2079
Historical keyword Nutrition From the Latin nutrire, to suckle, nurse, or nourish, the word came into English via Middle French to mean supplying or receiving nourishment—a meaning that it retains to this day. The importance of proper nutrition was recognised early: Hippocrates advised, “let your food be your medicine and your only medicine be your food”—an idea that has echoes in the modern expression “you are what you eat”. The word is rarely used figuratively, although the idea of “spiritual nutrition” appears in religious writings of the 16th and 17th centuries. Nutrition was also used from an early period for the nutritive contents or properties of food itself. Although foods and diets have been central to medical treatments since ancient times, only in the 19th century was research begun into specific nutritive properties. It has been said that James Lind’s 18thcentury researches into the treatment of scurvy initiated the modern scientific era of nutrition and its clinical investigation, but there was a long gap after Lind before the science of nutrition was begun. From the late 19th century nutrition began to acquire two further meanings. First, it was applied to the condition of being well or badly nourished. By the later 20th century, it was overlaid with economic notions of global division and was modified to “malnutrition” and “overnutrition”. Second, nutrition came to mean the study of food and diet, the branch of science that deals with nutrition. It was first used in this disciplinary sense in the journal Science in 1903. After the discovery of vitamins in the early 20th century, nutrition research became more sophisticated. The concept of “proper” nutrition, which had simply involved a full belly, now became complex. Nutrition also became a political issue during the depression of the 1930s, and has remained so, whether the concern is healthy school meals in the UK or food aid in developing countries. The weight of its political importance has, of course, changed over time, as have medical understandings of “proper”. By the 1990s, “proper” nutrition seemed to be significant in preventing a range of important illnesses, including heart disease and several cancers, although the quantification of the nutrients that “should” be eaten by each person, accommodating individual variation, remains problematic. Turkey good, Christmas pudding and brandy butter bad: but how much, dear doctor, how much?
Anne Hardy Wellcome Trust Centre for the History of Medicine at UCL [email protected]
www.thelancet.com Vol 366 December 17/24/31, 2005
Lifeline David Barnardo studied at the London Hospital, in the UK, and the Mayo Clinic, in the USA, before specialising in gastroenterology at Queen Mary’s Hospital, Roehampton, UK. Formerly a Board member of Tearfund, he has long been active in third-world development issues and, in retirement, chairs the children’s charity that bears his family name. What has been the greatest achievement of your career? Concluding my years of medical practice as chair of Barnardo’s, the UK’s premier children’s charity. And the greatest embarrassment? Taking a liver biopsy from a prominent public figure and driving over the container as I left the car park—biopsy retrieved from within the tyre tread. Who is your favourite politician and why? Tony Wedgewood-Benn, for uncompromising consistency, plain speech, and wit. Who was your most influential teacher and why? John Wright, physician at “The London” who sat on beds, held patients hands, and taught me humanity as a counterbalance to science, since patients are people. What do you think is the greatest political danger to the medical profession? Allowing politicians to come between us and our patients. What would be your advice to a newly qualified doctor? Enjoy the practice of medicine to the full and guard this against intrusion by bureaucracy. What alternative therapies have you tried? A hot water bottle at bedtime works wonders. What are you currently reading? Rough Crossings by Simon Schama—more examples of mankind’s self-deception and hypocrisy. What items do you always carry with you? Safety pin, paper clip, and elastic band. Do politics, spirituality, or religion play an important part in your life? Yes: we all need to seek spiritual as well as scientific answers to the big questions; for me, these are not mutually exclusive but complementary. With which historical figure do you most identify? My great-grandfather’s brother, Thomas John Barnardo (1845–1905). As a 21-year-old medical student, he committed his life to addressing the dreadful conditions that children had to endure in the east end of London—and then nationally. In his lifetime he provided care to 60 000 children, without distinction on grounds of race, religion, or disability (hence the ubiquitous sign “No Destitute Child Ever Refused Admission”). Barnardo’s now works annually with 140 000 children in various ways, but no longer through orphanages.
2079